Clinical Characteristics Of Bisphosphonate Jaw Osteomyelitis In Different Clinical Stages

Objective: Bisphosphonate osteomyelitis of the jaws(BRONJ)is an infectious disease that occurs in the maxillofacial bones after the use of bisphosphonates(BPs).Compared with other jaw osteomyelitis,it is slightly different in clinical features and treatment.The clinical characteristics and relevant examinations of bisphosphonate related osteonecrosis of the jaw were analyzed in order to provide a basis for clinical prevention.Methods: To retrospectively analyze the medical records of 18 patients diagnosed with BRONJ in the Oral and Maxillofacial Surgery Department of the First Affiliated Hospital of Xinjiang Medical University and Xinjiang Uygur Autonomous Region People’s Hospital from January 2013 to December 2020,including general information,laboratory examinations,etc.At the same time,the CBCT of purulent jaw osteomyelitis and healthy(no jaw disease)patients were collected,and the difference in bone density between the three was compared.The SPSS24.0 software package was used for statistical analysis of the data.Results: Among the 18 patients,7 were males(39%)and 11 were females(61%);17 cases had primary tumors,and 1 case had osteoporosis.Among them,5 cases(28%)used BPs for less than 12 months,9 cases(50%)from December to 36 months,and 4 cases(22%)for ≥36 months.The staging of 18 BRONJ patients were staged II or III.There was a statistically significant difference between the time of using BPs and BRONJ staging(P<0.05).There was no significant difference between the clinical symptoms and the treatment time after the use of BPs and the BROBJ staging,and the time between the use of BPs and the laboratory examination results(P>0.05).The results of bone density measurement showed that the BRONJ group in both areas was significantly higher than that in suppurative osteomyelitis group and the healthy group(P<0.05);while the bone density between the purulent jaw osteomyelitis group and the healthy group There was no significant difference(P>0.05).Conclusion: The longer the use of BPs drugs,the more severe the BRONJ infection.The measurement of bone density showed that the bone density of cancellous bone increased significantly after the use of BPs drugs,and it was more prone to osteonecrosis of the jaw.The imaging manifestations of the three types of osteomyelitis are also slightly different,and the treatment methods are also slightly different.There is currently no cure strategy for BRONJ,and the prognosis of the disease is poor,so the initial prevention of BRONJ is still the key to treatment.